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The Theology of the Body and Health Care [1]
by John M. Travaline, M.D.
Pope John Paul II’s “theology
of the body” is commonly viewed as papal teaching on
sexual ethics. While this is certainly true, it is so much
more than that, speaking to a variety of other day-to-day
matters. For example, in that it concerns the human body,
it informs people with bodily ailments and those who care
for them. Indeed, the theology of the body speaks to the healing
professions: nurses, therapists, doctors, religious, chaplains,
and all who tend to people when they are ill.
In this article, I offer a reading of John Paul II’s
view of the human person, as developed in his Theology
of the Body, that shows how we can understand one another
in the context of health care.
The Basic Problem
While recovering in the hospital following the assassination
attempt against him, John Paul II remarked that one of the
problems with being a patient is a threat to losing one’s
subjectivity. He recognized a tension between remaining a
“subject of one’s illness” and becoming
an “object of treatment.” [2]
Health care is, or should be, viewed in its essence as a healing
of the body-person. And at the center of this healing activity
is the relationship between the healer and patient.
An essential element of personhood is one’s capacity
to enter into relationships with other persons. This is fundamentally
based upon the reality that we are created in the image and
likeness of a relational, triune God. Further, the relationships
that characterize this sense of personhood are relationships
of love—or, in other terms, of complete self-donation.
The Body Is Made for Self-Donation
It is important for one who tends to the body in a healing
context to recognize that the essence of the body is to be
a gift to another. This notion finds its most clear expression
in the context of marriage, wherein the nuptial meaning of
the body is expressed. However, the body is apt for self-gift
in many ways and in many capacities, whether one is married
or unmarried.
In relationships in health care, there are at least two distinct,
relevant aspects of self-donation. First, the healer (or anyone
who tends to another who is ill) must be sensitive to the
patient’s disposition in allowing him or herself to
be cared for. In this way, the patient is actually being a
gift for the healer; he is giving the healer his vulnerability
and an opportunity for service.
Second, the healer has the opportunity to be a gift of self
to the patient during each and every encounter. The healer—through
his kindness, healing touch, and gentle words, and the use
of his knowledge to benefit the patient—makes a true
gift of himself in tending to the patient.
While many experiences afford us opportunities to be a gift
to one another, those who tend to the sick are especially
afforded opportunities for self-gift. Consider what Carl Anderson
writes: “In every Good Samaritan situation, then, there
is the invitation to give oneself and discover anew one’s
true self: a being created out of love, in the image of a
triune God, oriented toward others, with a great capacity
for love and, therefore, a greater capacity for joy.”
[3]
The Communion of Persons
In order to maintain a disposition of self-giftedness, particularly
with regard to those who are ill and are suffering, one must
appreciate the dignity of the person, who is created in God’s
image and willed for his own sake. Further, as God is a community
of persons—Father, Son, and Spirit—and as we are
made in His image, we also manifest a community of persons
in our relationships with others. In health care settings,
those who encounter the sick have the greatest—or at
least the most—opportunity on a regular basis for realizing
this anthropological reality.
In his apostolic letter on suffering, John Paul II talks
about suffering being present “in order to unleash love
in the human person” (Salvifici Doloris, no.
29). Who is on the front line confronting much of people’s
physical, emotional, and psychological suffering? Doctors,
nurses, and therapists. And confronting spiritual suffering?
Priests, ministers, and religious. In their call to the healing
professions, they all are invited to enter into a communio
personarum, a communion of persons.
Suffering also has a social and inter-human dimension (cf.
Salvifici Doloris, no. 8). And because of this, there
is an intimate relationship among suffering, communio,
and all of those who tend to the sick. Whenever an act of
kindness or mercy is given to another and that act is accepted,
a communion of persons is formed. [4]
It is a gift to be attended to and cared for. It is also
a gift to be the one who attends to the sick, who cares for
the other, because the other, in essence, is Christ. Recall
Jesus’ words: “I assure you, as often as you neglected
to do it to one of these least ones, you neglected to do it
to me” (Mt. 25:45). In giving oneself to another, one
becomes an instrument of Christ’s mercy. It is an honor
when one human being allows himself to be vulnerable in front
of another. Those who have received care know that it can
be quite difficult and humiliating, especially in this age
and culture when confidence, invincibility, and independence
are so prized. It is a gift to care for another because of
the basic rewarding feeling that one gets when one ministers
to another in need. It is indeed a gift to care for someone
who is ill; and in the interaction between the care-giver
and the patient, a communion of persons is formed. [5]
Examples of Communio personarum in Health
Care Settings
Let’s look at a few examples of communio personarum
that are present in health care.
First, consider the provision of artificial hydration and
nutrition to a patient in a state of permanent unconsciousness.
Such an action affirms the value and dignity of the patient
as a person. In the very act of caring for the person, solidarity
is maintained with the person, and the true meaning of compassion
is realized. This notion of maintaining solidarity, communion,
or connectedness with a patient is critical to understanding
relationships with the sick as reflecting communio personarum.
Maintaining solidarity affirms the dignity of the person and
promotes good realized by both the one tending to the patient
and the patient himself, even if the patient is in a state
of permanent unconsciousness, and even if the patient may
not perceive benefit. [6]
Second, consider the impact of spousal health on the care-giving
spouse’s own health and mortality. This was the subject
of an article in the New England Journal of Medicine
in which nearly 520,000 couples were studied to explore this
relationship. [7]
Over 730,000 spouses were hospitalized at least once over
nine years of observation. Without getting into the details
of the study, the bottom line was that hospitalization of
a spouse is associated with an increased risk of the death
of the care-giving spouse. Doesn’t this seem to reveal
some profound truth about the complete self-donation of spouses?
Is this not a manifestation of communio personarum?
And, that this study concerns spouses; the nuptial union;
is this not the primordial communio personarum?
Lastly, in another study, over 12,000 elderly patients were
analyzed with respect to their satisfaction with physician
care. [8]
The authors found that if someone accompanied the patients
on medical visits, the patients were more satisfied with their
interaction and relationship with their physician and their
physician’s care of them. Here again is evidence demonstrating
an aspect of the communion of persons and the benefit of self-giving.
Patients accompanied by another person, spouses caring for
each other, persons caring for patients even when the patient
has no awareness; all are manifestations of communio personarum
evident in our clinics, hospitals, and nursing homes every
day.
Threats to the Body and the Communion of Persons
Present day realities reside within the medical field that
threaten human freedom, assail human personhood, and blur
the distinctions between men and women as created uniquely
in the image and likeness of God. Sadly, the medical professions
do not unanimously reject these realities. For this reason,
various organizations and faithful laity fight these anti-person,
anti-life forces, and they work to preserve a culture of life,
uphold authentic human freedom, and convey hope in the midst
of suffering.
Let’s look at some of the issues and practices that
degrade the human person as created male and female in the
image and likeness of God. These threatening forces may be
categorized according to the primary mechanism by which they
destroy the authentic meaning of personhood.
Category 1: Issues that blur the distinction between
man and woman. These include homosexual agendas
(such as same-sex marriage and domestic partnership arrangements)
and gender re-assignment surgery.
Category 2: Issues that see the person as primarily
an object to be used. These include certain organ
procurement practices for organ transplantation; possibly
donation after cardiac death; embryonic stem cell research
and development; and euthanasia and physician-assisted suicide.
Category 3: Issues that rupture communio personarum.
These include various reproductive technologies
(such as contraception and in vitro fertilization)
and an erosion of medical professionalism.
Response to the Threats
The theology of the body exposes these practices in our society
as lies about who we are. Unfortunately, we can be duped,
and in this case, duped into sustaining a culture of death.
The theology of the body tells us that same-sex marriage and
gender re-assignment are incompatible with who we truly are.
God is a Trinity; in His image we, therefore, must be relational.
And we are; created as male and female to relate to each other
in a self-donative way. The theology of the body tells us
that certain organ procurement practices, embryonic stem cell
research, and physician-assisted suicide are direct assaults
on the person created for love relationships—persons
who are not to be used as commodity or discarded as useless
or unwanted. The theology of the body tells us that various
reproductive technologies also are lies, breaking down the
truth of man and woman, made for nuptial relationship and
made to share in communio personarum.
John Paul II’s teaching on the theology of the body
is a crucial element in our response to forces threatening
our society, particularly in matters of health care. Its relevance
to health care is undeniable, and everyone, whether directly
or indirectly involved with caring for the sick, will be enriched
by an integrative view of the person as packaged and delivered
in The Theology of the Body.
[1]
A version of this article was presented at the 77th Annual
Educational Conference of the Catholic Medical Association,
“Theology of the Body: Modern Challenges to Health,
Conscience, and Human Dignity,” in Baltimore, Maryland,
on October 9, 2008.
[2]
George Weigel, Witness to Hope: The Biography of Pope John
Paul II (New York, NY: HarperCollins, 2005), p. 415.
[3]
Carl Anderson, A Civilization of Love, What Every Catholic
Can Do to Transform the World (New York, NY: Harper Collins,
2008), p. 63.
[4]
Mary Healy, Men and Women Are from Eden: A Study Guide to
John Paul II’s Theology of the Body (Cincinnati, OH:
Servant Books, 2005), p. 26.
[5]
Tara L. Seyfer and John M. Travaline. The Theology of the
Body and modern medicine: informing the practice of healing.
Linacre Quarterly 2008; 75:16-30 (February 2008).
[6]
See pages 180 ff, Germain Grisez’s essay in Artificial
Nutrition and Hydration, and the Permanently Unconscious Patient.
Ronald P. Hamel and James J. Walter, editors. Georgetown University
Press, 2007.
[7]
Nicholas A. Christakis and Paul D. Allison. Mortality after
hospitalization of a spouse. N Engl J Med 2006; 354:719-30.
[8]
Jennifer L. Wolff and Debra L. Roter, “Hidden in Plain
Sight,” Archives of Internal Medicine, 168 (2008): 1409–15.
John M. Travaline is a physician and professor of medicine
at Temple University School of Medicine. He is in formation
for the permanent diaconate for the Archdiocese of Philadelphia,
and resides with his wife, Cathy, and their four children
in suburban Philadelphia.
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